Ayurveda and Cholesterol: The Unjustly Villained
Updated: Aug 31
I guarantee that if you spend 2 minutes at the pharmacy counter, you'll witness a customer buying statins to lower cholesterol and reduce cardiovascular risk. In 2018, an estimate based on data from 83 countries indicated that approximately 145.8 million people were using statins .
But what exactly is cholesterol? And why has it gained the reputation of being a major enemy of the heart? (right after your toxic ex)
🥑 First: cholesterol is not a poison.
Cholesterol is a fat-like substance found in all cells of our body. We need it to maintain cell membranes, produce steroid hormones, vitamin D, and bile acids, among other functions.
The problem isn't simply "having cholesterol." The problem is having certain lipoproteins in excess, especially LDL, within a metabolic context that favors the formation of plaques in the arteries .
💔 LDL and HDL: which is which?
Technically, LDL and HDL are not different types of cholesterol. They are lipoproteins , particles that transport cholesterol and other lipids through the blood.
• HDL — the famous “good cholesterol”
HDL participates in the reverse transport of cholesterol, carrying cholesterol from the tissues back to the liver, where it can be processed and eliminated.
• LDL — the infamous “bad cholesterol”
LDL carries cholesterol from the liver to the tissues, where it is needed. The problem arises when there are excess LDL particles circulating and penetrating the arterial wall, contributing to the formation of atherosclerotic plaques.
An important point to note: LDL becomes especially problematic when it undergoes modifications through oxidative processes . Oxidized LDL is more easily retained in the artery walls and contributes to the formation and progression of atherosclerotic plaque. In other words, it's not just the quantity of LDL, but also the metabolic context in which it circulates that matters.
Both have important functions. The problem is when one of them loses sight of personal space and creates imbalance.
❤️🩹 And why is high cholesterol a concern?
Because an excess of certain lipoproteins, mainly LDL, can contribute to the formation of plaques on the walls of arteries. Over time, these plaques can narrow the vessels, and when a plaque ruptures and triggers the formation of a clot, blood flow can be blocked.
That's where problems like the following come in:
🫀 Coronary heart disease and heart attack
🧠 Stroke
🦵 Peripheral arterial disease
And there's an important irony: high cholesterol usually doesn't cause symptoms. You can feel perfectly fine and still have a lipid profile that warrants attention.
🧪 And the numbers?
Generally speaking, for adults:
• LDL: below 100 mg/dL is considered desirable for many people.
• HDL: 60 mg/dL or higher is considered favorable; values below 50 mg/dL in women and below 40 mg/dL in men are considered low in some classifications.
•Triglycerides: below 150 mg/dL is considered normal. But those with levels below 100 mg/dL get a gold star.
A simple way to look at the lipid profile* is to calculate some ratios:
• LDL ÷ HDL → < 2 = very good | 2–3 = average/adequate | > 3 = higher risk
• Total cholesterol ÷ HDL → < 3.5 = very good | 3.5–5 = average/adequate | > 5 = higher risk
(To calculate, simply divide the first number by the second. Ex.: LDL 90 ÷ HDL 60 = ratio 1.5 — very good.)
*These reasons help to contextualize the examination, but do not replace the assessment of LDL, non-HDL, and individual cardiovascular risk.
But be aware: laboratory values are like quirks: everyone has their own. The LDL target depends on individual cardiovascular risk. For a person who has already had a heart attack, stroke, or has certain high-risk conditions, for example, the target may be considerably lower. Therefore, looking only at total cholesterol—or at a simple ratio between HDL and LDL—may be insufficient. The test needs to be interpreted within the context of the individual .
🤷🏽 But how did we get here?
The history of cholesterol is long, and full of gossip and intrigue.
During the 20th century, research linked blood cholesterol, saturated fat, and cardiovascular disease. This famous hypothesis gained enormous traction and helped transform fat into one of the great villains of modern diets. In March 1984, Time magazine published the famous cover "Cholesterol. And Now the Bad News," reporting on the results of the LRC-CPPT study, which investigated cholesterol reduction and its effects on coronary heart disease. We now know that the results of this study were manipulated for the benefit of the industry. Conspiracy theory? Maybe! But I also provide evidence: here
Today we know that it is not correct to turn "fat" into a single category , just as it is not correct to turn cholesterol into an absolute enemy. The effect of saturated fat, for example, depends in part on what replaces it in the diet. Replacing it with unsaturated fats can have different effects than replacing it with refined carbohydrates and sugars.
In other words, the question shouldn't simply be: "Is fat bad for you?"
But: "Which fat? In what quantity? In what metabolic context? And replacing what?"
🥇 And is cholesterol important for health?
✨Very. And much more than your skincare routine✨:
🧠 Nervous system: cholesterol is an important component of cell membranes and myelin, the structure that surrounds and protects nerves.
🩸 Cell membranes: help maintain the proper structure and fluidity of membranes.
💪🏽 Hormone production: it is a precursor to several steroid hormones.
☀️ Vitamin D: participates in the vitamin D production pathway.
🔥 Digestion: It is used in the production of bile acids.
We need cholesterol. What we need to avoid is an excess of certain lipoprotein particles and, especially, the metabolic context that favors cardiovascular disease.
🌱 And what does Ayurveda have to say?
This is where I shine. I mean, your agni shines.
Ayurveda does not use cholesterol, LDL, and HDL as traditional diagnostic categories. Therefore, we shouldn't simply take a modern test and say that "high LDL = a certain dosha." But we can make a metabolic assessment of the problem.
And in this context, there are some fundamental steps:
🔥 1. Agni .
Agni is your ability to digest, absorb, and metabolize what you consume. It also relates to your gastrointestinal microbiome, which plays a role in these functions as well. It's not enough to simply ask, "What are you eating?" We also need to ask, "How is your body processing what you're eating?"
We also need to cultivate a balanced and functional Agni ( digestive fire). The idea is not simply to "eat something good and expect it to solve everything." It's about promoting digestion and metabolism capable of properly processing what we ingest, nourishing tissues, and preventing metabolic buildup.
That is precisely why, in Ayurveda, diet and metabolism go hand in hand.
It's not just what goes into the body. It's also what the body is able to do with what has gone in. And I've already written an entire post about that: how to build a strong and healthy Agni.
🫒 2. Proper nutrition
No brainer, right?
🌰 prioritize sources of unsaturated fats, such as olive oil, avocado, nuts, and seeds;
🥦 Increase the variety of vegetables and include foods rich in fiber;
🥣 Include foods that naturally help lower cholesterol: oats, apples, citrus fruits,
🍬 Reduce excess sugar and refined carbohydrates;
🍞 Pay special attention to foods that promote increased triglycerides and worsen metabolic health;
🚫 Reduce trans fats and moderate your consumption of saturated fats, according to your individual circumstances.
💊 Red yeasted rice has proven effective in reducing cholesterol, but it needs to be prescribed by a health professional as it has contraindications.
🧬 And what about genetics?
Yes. Genetics matters. There are people with a significant genetic predisposition to high LDL levels, including conditions such as familial hypercholesterolemia.
But genetics doesn't mean destiny. In fact, in most cases, as a cause, it's way down on the list, well after diet and lifestyle. So don't blame genetics exclusively to become enslaved to a little pill and throw caution to the wind when it comes to what really matters: diet, physical activity, body composition, sleep, stress, and metabolism.
🧬 Statins
Statins are necessary and very important in certain cases , especially when cardiovascular risk is high. I'm not against statins—I'm against treating cholesterol as a universal villain and then turning statins into a universal solution.
In my view, considering the decades-long history of demonizing cholesterol, these medications are overprescribed. And indiscriminately reducing cholesterol isn't exactly a neutral strategy: we're talking about a substance the body needs for the brain and nervous system, cell membranes, hormones, vitamin D, and much more. Especially in old age, when we don't need less care for these functions—we need more.
🖊️ And what about those famous "slimming pens"?
GLP-1 receptor agonists—and related medications—have significantly changed the treatment of obesity and, in certain populations, have also demonstrated cardiovascular benefits. But this does not mean they are a magic bullet for metabolism.
Weight loss can also involve loss of lean mass, and the use of these medications needs to be monitored individually, especially when there is rapid weight loss or prolonged use.
From an Ayurvedic perspective, these treatments end up further weakening your agni (remember?) which is primarily responsible for directing your cholesterol to where it should go and preventing it from causing blockages in your arteries.
But if you need this support now, it's necessary to continue taking care of what sustains metabolic health: proper nutrition, sufficient protein, weight training or other muscle stimulation, movement, sleep, professional monitoring, and redoubling your care for your agni. (did someone have agni 35 times in their bingo card?)
And of course: prescribed medication is medication to be used as directed and under the supervision of a doctor — not according to internet trends.
🧟 In the end...
The biggest mistake we make is always having to look for a single villain. First it was fat, then gluten (Read: All about gluten, flour, bread ...), then sugar. (This is the real official villain. Read: Reducing sugar cravings )
The human body is far more sophisticated than that. Cardiovascular health isn't about demonizing a nutrient. It's about understanding metabolism as a system.
A thousand rules and fads appear on the internet every day, confusing consumers about what really makes sense. That's where the Ayurvedic perspective and the concept of agni come in to simplify things: "How is my body receiving, processing, absorbing, metabolizing, and excreting what it receives?" The answer is ALWAYS in the power of your agni. (There's that word again... 🙄)
To a life (and agni) in balance,
Grazie Prokopetz
Doctor of Ayurveda
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